The Effectiveness of Pelvic Floor Muscle Training in Men after Radical Prostatectomy Measured with the Insert Test.

A commonly used physiotherapeutic method for the treatment of urinary incontinence (UI) after radical prostatectomy (RP) is pelvic floor muscle training (PFMT). The aim of this study was to evaluate the effectiveness of PFMT by enhanced biofeedback using the 1h pad-weighing test. The following factors were taken into consideration in the analysis of PFMT effectiveness: the relevance of the patients' age, time from RP, BMI, mental health, functional state, and depression. A total of 60 post-RP patients who underwent 10-week PFMT were studied. They were divided into groups: A (n = 20) and B (n = 20) (random division, time from RP: 2−6 weeks) and group C (time from RP > 6 weeks). Group B had enhanced training using EMG biofeedback. UI improved in all groups: A, p = 0.0000; B, p = 0.0000; and C, p = 0.0001. After the completion of PFMT, complete control over miction was achieved by 60% of the patients in group A, 85% in group B, and 45% in group C. There was no correlation between the results of PFMT efficacy and patients' age, BMI, time from RP, mental health, functional state, and depression. PFMT is highly effective in UI treatment. The enhancement of PFMT by EMG biofeedback seems to increase the effectiveness of the therapy.

Efficacy of Manual Therapy Including Neurodynamic Techniques for the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Trial.

OBJECTIVE: The purpose of this randomized trial was to compare the efficacy of manual therapy, including the use of neurodynamic techniques, with electrophysical modalities on patients with mild and moderate carpal tunnel syndrome (CTS). METHODS: The study included 140 CTS patients who were randomly assigned to the manual therapy (MT) group, which included the use of neurodynamic techniques, functional massage, and carpal bone mobilizations techniques, or to the electrophysical modalities (EM) group, which included laser and ultrasound therapy. Nerve conduction, pain severity, symptom severity, and functional status measured by the Boston Carpal Tunnel Questionnaire were assessed before and after treatment. Therapy was conducted twice weekly and both groups received 20 therapy sessions. RESULTS: A baseline assessment revealed group differences in sensory conduction of the median nerve (P < .01) but not in motor conduction (P = .82). Four weeks after the last treatment procedure, nerve conduction was examined again. In the MT group, median nerve sensory conduction velocity increased by 34% and motor conduction velocity by 6% (in both cases, P < .01). There was no change in median nerve sensory and motor conduction velocities in the EM. Distal motor latency was decreased (P < .01) in both groups. A baseline assessment revealed no group differences in pain severity, symptom severity, or functional status. Immediately after therapy, analysis of variance revealed group differences in pain severity (P < .01), with a reduction in pain in both groups (MT: 290%, P < .01; EM: 47%, P < .01). There were group differences in symptom severity (P < .01) and function (P < .01) on the Boston Carpal Tunnel Questionnaire. Both groups had an improvement in functional status (MT: 47%, P < .01; EM: 9%, P < .01) and a reduction in subjective CTS symptoms (MT: 67%, P < .01; EM: 15%, P < .01). CONCLUSION: Both therapies had a positive effect on nerve conduction, pain reduction, functional status, and subjective symptoms in individuals with CTS. However, the results regarding pain reduction, subjective symptoms, and functional status were better in the MT group.

Effect of manual therapy and neurodynamic techniques vs ultrasound and laser on 2PD in patients with CTS: A randomized controlled trial.

STUDY DESIGN: Randomized controlled trial. INTRODUCTION: Two-point discrimination (2PD) test can be used to assess both clinical condition and the effects of therapy in carpal tunnel syndrome (CTS) patients. PURPOSE OF THE STUDY: To determine whether there are specific differences in 2PD between symptomatic and asymptomatic hands in CTS patients and to evaluate the impact of 2 therapy regimes on 2PD in patients with CTS. METHODS: Therapy for the neurodynamic mobilization group was based on manual therapy and neurodynamic techniques. Therapy for the electrophysical modalities group was based on red and infrared laser and ultrasound therapy using a contact method applied in the transverse ligament area. Therapeutic cycle consisted of 20 therapy sessions delivered at twice-weekly intervals. RESULTS: After therapy, 2PD in the symptomatic limbs in the neurodynamic mobilization and electrophysical modalities groups significantly improved (p < .001). However, there was no statistically significant difference between the treatment groups. CONCLUSIONS: Both therapy programs used in this study were beneficial for improving 2PD. LEVEL OF EVIDENCE: 2.

The effect of Saunders traction and transcutaneous electrical nerve stimulation on the cervical spine range of motion in patients reporting neck pain - pilot study.

INTRODUCTION: It is estimated that about 80% of the general population occasionally experience spinal pain, with as many as 50% reporting pain in the cervical spine. The aim of this study was to determine the effectiveness of treatment of cervical spine pain with the Saunders traction device and transcutaneous electrical nerve stimulation (TENS) by assessing their impact on the cervical spine range of motion in the sagittal, coronal and horizontal planes. MATERIAL AND METHODS: A total of 39 patients aged 26 to 62 years took part in the study. All patients reported chronic cervical spine pain caused by overload and postural insufficiency. The participants were randomly divided into three experimental groups. The first group was treated with Saunders traction where the traction force was administered so that the patient would experience noticeable but painless traction. The second group received traction as well as classic transcutaneous electrical nerve stimulation, whereas the third group received only TENS. Each patient attended 10 treatment sessions not more than three days apart. Measurements of the range of motion were performed with the CROM instrument before and after the first session, after the fifth and tenth session and about three weeks after completion of rehabilitation. RESULTS: The study revealed the greatest ROM improvement in the coronal and horizontal planes and for the extension motion. CONCLUSIONS: The best therapeutic effect was obtained by combining traction with transcutaneous electrical nerve stimulation.

Assessment of the influence of Saunders traction and transcutaneous electrical nerve stimulation on hand grip force in patients with neck pain.

BACKGROUND: Spinal pain syndromes are among the most frequent causes of ill health. Long-lasting sustained overload results in a critical decrease in the distance between neighbouring vertebrae and radiation of pain. The aim of this study was to assess the effect of cervical traction and the TENS method on the strength of painless grip and maximum strength of the arm flexors. MATERIAL AND METHODS: The study included 45 patients with overload-induced cervical pain, ranging in age from 21 to 66 years. The patients underwent a therapy based on the Saunders traction device and the TENS method. The traction force was regulated so that the patient would feel noticeable but painless traction. The TENS procedure was performed using the conventional method. The patients were divided into three groups. The Saunders traction device was used in the first group, transcutaneous electrical nerve stimulation and traction were applied in the second group, while the patients in the third group were received TENS only. Each patient underwent 10 treatment sessions with intervals between sessions not exceeding three days. RESULTS: The results showed the greatest improvement in the strength of painless hand grip. Maximum strength increased only on the left side in the group which received only the traction treatment. CONCLUSIONS: The use of the Saunders cervical traction device produced an increase in painless hand grip strength in patients with cervical spine pain. Both treatments had a limited effect on maximum hand grip strength.

Induced static asymmetry of the pelvis is associated with functional asymmetry of the lumbo-pelvo-hip complex.

OBJECTIVE: This study evaluates the hypothesis that triggering and eliminating induced static pelvic asymmetry (SPA) may be followed by immediate change in functional asymmetry of the lumbo-pelvo-hip complex. METHODS: Repeated measures experimental design with 2 levels of independent variable, that is, induced SPA triggered and induced SPA eliminated, was implemented. Three series of measurements were performed, that is, baseline, after triggering SPA, and after eliminating SPA. A group of 84 subjects with no initial symptoms of SPA was studied. Different forms of mechanical stimulation were applied aiming to induce SPA, and the 2 manual stretching-manipulating techniques were performed aiming to eliminate it. A hand inclinometer was used to measure SPA in standing posture. Selected ranges of motion of the hip joints and lumbar spine were used to depict functional asymmetry of the lumbo-pelvo-hip complex. The functional asymmetry indices for individual movements were calculated. Repeated measures design of analysis of variance, dependent data Student t test, and linear Pearson's correlation test were used. RESULTS: Assessment of the SPA showed its significant increase between baseline and series 2 measurements, with a subsequent significant decrease between series 2 and series 3 measurements. Values of the functional asymmetry indices changed accordingly, that is, they increased significantly between series 1 and series 2 and had returned to their initial level in series 3 measurements. CONCLUSIONS: Induced SPA shows considerable association with functional asymmetry of the lumbo-pelvo-hip complex.